Treatment for iron deficiency anaemia usually involves taking iron supplements and changing your diet to increase your iron levels, as well as treating the underlying cause.

Iron supplements

Your GP will prescribe an iron supplement to restore the iron missing from your body. The most commonly prescribed supplement is ferrous sulphate, which is taken as a tablet two or three times a day.

Some people can experience side effects when taking iron supplements, including:

• abdominal (tummy) pain
• constipation or diarrhoea
• heartburn
• feeling sick
• black stools (faeces)

These side effects should settle down over time, although your GP may advise taking the tablets with food or shortly after eating to help minimise side effects, if they are severe. Your GP may also recommend you only take one or two tablets a day, instead of three, if you are finding side effects difficult to cope with. 

If you cannot take ferrous sulphate because you get severe side effects, you may be prescribed a different iron supplement called ferrous gluconate. This supplement should cause fewer side effects, as it contains a less concentrated dose of iron. However, it may take longer for iron levels in your body to be restored.

In a few cases – for example, if you have chronic kidney disease (CKD) – iron injections may be recommended instead of tablets.

Storing iron supplements

As with all medications, it's important to store iron supplements out of the reach of children. This is because an overdose of iron supplements in a young child can be fatal.

Dietary advice

If a lack of iron in your diet is thought to contribute to your iron deficiency anaemia, your GP will tell you how to include more iron in your diet.

Iron-rich foods include:

• dark-green leafy vegetables, such as watercress and curly kale
• iron-fortified cereals or bread
• brown rice 
• pulses and beans
• nuts and seeds
• white and red meat
• fish
• tofu
• eggs
• dried fruit, such as dried apricots, prunes and raisins

You should also try and include foods from all major food groups in your diet, to ensure it is healthy and well-balanced. In particular, you should try to include foods and drinks containing vitamin C, as vitamin C can help your body to absorb iron.

However, high levels of some foods and drinks, as well as certain medicines, may make it harder for your body to absorb iron. These include:

• tea and coffee
• calcium, found in dairy products such as milk
• antacids and proton pump inhibitors (PPIs), which are medications sometimes used to relieve indigestion
• wholegrain cereals – although wholegrains are a good source of iron themselves, they contain phytic acid, which can stop your body absorbing iron from other foods and pills

If you are finding it difficult to include iron in your diet, you may be referred to a dietitian (a health professional who specialises in nutrition). They can give you detailed, personalised advice about how you can improve your diet.

Treating the underlying cause

Your GP will also need to ensure the underlying cause of your anaemia is treated, so it doesn't happen again.

For example, if non-steroidal anti-inflammatory drugs (NSAIDs) are causing bleeding in your stomach, your GP may prescribe a different medicine to help minimise the risk of stomach bleeding.

Heavy periods can be treated with medication and, in particularly severe cases, surgery. Read more about treating heavy periods. 

Monitoring

Your GP will ask you to return for a check-up two to four weeks after you have started taking iron supplements, to check how well you have responded to the treatment. Your haemoglobin levels will be checked in a blood test.

If the result of the blood test shows an improvement, you will be asked to continue taking your iron supplements and return in two to four months for another blood test.

Once your haemoglobin levels and red blood cells are normal, your GP will usually recommend you continue taking iron supplements for three months to help build up the iron levels in your body.

After this, depending on the cause of your iron deficiency anaemia, you should be able to stop taking the supplements. Your condition will then be monitored every three months, over the course of a year, and again a year later.

Continuing treatment

In some people, after iron levels in the body have been replenished, they start to fall again.

This could happen if you don't get enough iron in your diet, you are pregnant or you have consistently heavy periods.

If this happens, you may be prescribed an ongoing iron supplement to help stop your anaemia returning. This will usually be in tablet form, which you will have to take once a day. 

If treatment is ineffective

If your iron levels do not improve, your GP will ask how regularly you have been taking your iron supplements. Some people are put off taking the medication because of the side effects (see above). However, your condition will not improve if you don't take the supplements.

If you have been taking the supplements as prescribed and your iron levels have still not improved, your GP may refer you to a specialist for a assessment.